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Commenting on an earlier paper in this Journal (January, 1971) which discusses ‘demand’ and ‘need’ for medical services, the authors present another framework for analysis. A rejoinder by the authors of the original paper follows. [ABSTRACT FROM AUTHOR]

This paper presents a group process for conducting an exploration of the qualitative and quantitative elements, patterns and total structure of a health care problem under preliminary investigation. Reasons for employing the nominal group process as a pilot research instrument are given. The authors emphasize that it is appropriate for some problems but not for others. [ABSTRACT FROM AUTHOR]

This paper endeavors to show how a systems approach may be applied to project selection and budget allocation in comprehensive health planning. After detailing the steps to be taken, an actual case is discussed. [ABSTRACT FROM AUTHOR]

This paper describes and discusses the evolution and operation of a patient advisory committee to a family planning program. The concerns and activities which have occupied the Committee are presented. Successes and frustrations of professionals and consumers are elucidated and changes in progress are noted. [ABSTRACT FROM AUTHOR]

Health manpower is a major factor in the provision of health care. Licensure of personnel is not the only factor affecting the main problems of health manpower but it has an influence on very many aspects (wages and working conditions, educational requirements, administrative and organizational patterns and many others). This paper discusses how licensure should contribute to sound solutions and constitute an obstacle. [ABSTRACT FROM AUTHOR]

This paper discusses the methods and the results of a forecast for the demand for operative and obstetrical procedures and the supply of anesthesiologists in Cuyahoga County, Ohio. The techniques and results of a ten-year forecast for the demand for and supply of anesthesiologists and auxiliary personnel in greater Cleveland are discussed. Several regression models were used to forecast supply based on population, number of physicians, and the income per capita. The demand models were based on population, age and sex distribution projections, and historical data regarding operative and obstetrical procedures. The results of these "objective" models were then compared to forecasts under uncertainty generated by a panel of experts using the Delphi Method. Alternative states of health care delivery were investigated and implications for future anesthesiologist manpower requirements detailed. [ABSTRACT FROM AUTHOR]

This paper presents the characteristics of the regular source of care identified for children in a household survey and relates these to perceived accessibility of services. Except in the preschool age group, a minority of children have a pediatrician as their regular source of care. Availability of services at various times during the week is not consistently related to specialty or to board certification but geographic access to pediatricians, especially board-certified pediatricians, is more difficult than is access to other types of physicians. This is evidenced by a greater need to make appointments (except in emergencies), and more remote, less convenient location of physicians' offices. Family income is related to the type of physician identified even among families who pay out-of-pocket the entire office visit fee. Accessibility of services should be considered with quality and cost in evaluating the adequacy of health care. [ABSTRACT FROM AUTHOR]

The study assess the extent of utilization of preventive health care services by eligible residents of low income neighborhoods in the U.S. Previous studies have indicated that preventive health services are underutilized by poor Americans. In fact, this relative lack of preventive care seems to be one of the reasons why poverty and a minority status tend to correlate with higher morbidity and mortality rates. This study was undertaken based on the assumption that the new comprehensive clinics set up in Los Angeles in the late nineteen-sixties afforded new possibilities for preventive health care.

The article explores the need for public health professionals to respond to the challenges of the changing environment and the increasing need for health care in the U.S. According to experts, the first and most critical health problem facing the nation is on the delivery of health services and medical care. The second major problem facing the nation is the matter of population growth and the right of a female to control the reproductive organs of her own body. The third problem facing our nation and the world is that of the environment and its rapid deterioration. The fourth area changing the scene in public health is the problem created by the growing burden of mental illness, drugs, and alcoholism.

The development of an information system for a state health department is considered in terms of cybernetic and information theories. [ABSTRACT FROM AUTHOR]

The article focuses on the response accuracy of a sample of poor African American welfare mothers in New York. They were New York City residents receiving public assistance in 1966 who had been interviewed by the National Opinion Research Center for a study on the use of health services. The African American welfare mothers in the study voted much less often than other groups studied. Only 29 percent voted in the 1964 election. Nevertheless, they acknowledge their nonvoting with as much candor as other groups. Two sets of characteristics distinguish the accurate from the biased respondent on the voting questions. The biased respondent is high on community integration. The fact that the same characteristics that are associated with voting are associated with response bias distorts not only the absolute figures but also the analysis of relationships among variables. It is usually assumed that social distance between respondent and interviewer will adversely affect response accuracy. Disparities in social status were limited to socioeconomic status, education and age. It was expected that welfare mothers would give the interviewers most unlike themselves a more biased, idealized story.

The relationship between income and physician visits, especially the assumption that the poor underutilize physician services is reexamined and tested with data from a survey of Rhode Island residents. The National Center for Health Statistics publications on the Volume of Physician Visits show a changing pattern in the use of physician services among income groups during the interval between 1960 and 1968. These data are complemented by findings from a 1971 survey of Rhode Island adults that show an inverse relationship between income and physician visits. The inverse trend in the Rhode Island data goes beyond the national pattern of a flattening of income differentials. The tendency for lower income respondents to be more likely to report physician visits during the previous sixty days as compared to visits reported by persons with larger incomes persisted even when controls were introduced for a number of related factors such as age, the mode of health care delivery used, and the presence of restricted activity days during the time period being studied. The accessibility of publicly financed medical care was found to be associated with use of physician services. [ABSTRACT FROM AUTHOR]

The major thrust of this year's presidential address is the urgent need for a clearly defined national health program. By offering an outline in which specifics are used for illustration, the reader is given an opportunity to consider the basic aspects and how to develop and implement such a program. [ABSTRACT FROM AUTHOR]

Describes the historical background of the development of social security programs providing medical care in Latin America. Topics discussed regarding medical care.

This article focuses on the role of the federal government of the U.S. in the financing of medical care. The objective of government financing of medical care is frequently expressed as either achieving equal access to care regardless of income or removing income as a barrier to the consumption of medical care or assuring everyone a minimum level of care. It is believed that achieving equal access to health care irrespective of income is not equivalent to assuring all individuals some minimum level of care. The efficient method of achieving the latter is to increase the consumption of those below the minimum. The efficient method of achieving the former is to simultaneously increase the consumption of those at the bottom and decrease the consumption of those at the top. While a nationalized free health service system would be an inefficient method of achieving the minimum provision objective, it could conceivably be the most efficient method of achieving equal access. But, a necessary condition for free provision to be a more efficient alternative than pure subsidization might be artificial restriction of supply.

This article seeks to analyze the relationship between the distance that farm families reside from certain health personnel and facilities and (1) the incidence of bed illness at home among those families and (2) the use of such health resources. The analysis is based on information obtained on 1,947 persons, 15 to 64 years of age, in 858 farm-operator households. The data are from 10 counties of a 20-county sample used in a survey of morbidity in contrasting socio-economic areas in Missouri. Generally, it was found that persons who live at the greater distances from certain health personnel tend to have a lower physician-call rate and more days of bed illness than those relatively nearby. No clear-cut relationship between distance to hospital and incidence of bed illness at home was found. The findings have implications for the development of any public or private health programs and suggest consideration of distance as one of the factors in the location of health personnel. [ABSTRACT FROM AUTHOR]